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 Ilene Busch-Vishniac
Sonavi Labs 1100 Wicomico Street Suite 600 Baltimore, Maryland 21230 USA
Erica Ryherd
Durham School of Architectural Engineering and Construction University of Nebraska-Lincoln 1110 South 67th Street Omaha, Nebraska 68182 USA
Hospital Soundscapes:
Characterization, Impacts,
and Interventions
Hospital soundscapes do not currently project the aura of calm and restfulness that patients and staff would prefer to experience.
Although hospitals are ubiquitous today, the contemporary hospital only emerged in the eighteenth century, in China and in parts of Europe. As hospitals grew more numerous and more accepted as central providers of healthcare, they became much more crowded. By the mid-nineteenth century, concerns about the noise in hospitals were already arising. For instance, Florence Nightingale noted in 1859 “unnecessary noise, then, is the most cruel absence of care which can be inflicted either on sick or well” (Nightingale, 1859).
Much has changed since the introduction of hospitals. Their operations have dra- matically expanded, their customer base and their size have changed significantly, and the use of technology has transformed them. One of the constants, though, is that hospitals have always been considered to be noisy by patients and staff. Papers on hospital noise appear continuously in the research literature starting in the 1860s and continuing until today.
The first studies of hospital noise focused on objective measures, with modest attempts at interventions. Such studies continue to be published today. It has been difficult to draw detailed conclusions from these studies, however, because the hos- pital environment depends on a large number of factors, including the building design and materials, the number of patients, staff and visitors present, the intensity of the challenges of patients (which dictates the medical equipment present), and the communications technologies used.
Starting in the mid-twentieth century, studies emerged linking the sound in hospitals to the impacts on patients and staff. Again, this work has illuminated hospital issues slowly because it is very difficult to vary only the sound levels in a hospital environ- ment. There are simply too many confounding factors in real hospital situations.
More recently, there is a growing focus on using the statistical approaches of sound- scape analysis to study hospital environments. Soundscapes refer to the reactions of humans to sounds in context and have been used in many contexts (see, e.g., Brooks et al., 2014; Schulte-Fortkamp et al., 2007). Soundscape analysis uses statistical approaches from psychology to determine what factors are important rather than trying to modify one factor at a time and examine reactions.
Characterizing the Sound in Hospitals
A good bit of the history of noise control could be subtitled “The Search for the Perfect Noise Metric.” In buildings, near airports, near highways, and in nature preserves, we have tried to find that single measure of the acoustic environment that
©2019 Acoustical Society of America. All rights reserved. volume 15, issue 3 | Fall 2019 | Acoustics Today | 11

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